Provider Demographics
NPI:1972700144
Name:PULASKI COUNTY SHELTERED WORKSHOP
Entity Type:Organization
Organization Name:PULASKI COUNTY SHELTERED WORKSHOP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:GIFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-765-2500
Mailing Address - Street 1:PO BOX 914
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:MO
Mailing Address - Zip Code:65556-0914
Mailing Address - Country:US
Mailing Address - Phone:573-765-2500
Mailing Address - Fax:573-765-2503
Practice Address - Street 1:#3 INDUSTRIAL DRIVE
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:MO
Practice Address - Zip Code:65556-0914
Practice Address - Country:US
Practice Address - Phone:573-765-2500
Practice Address - Fax:573-765-2503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOSB40-1347B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347B00000XTransportation ServicesBus